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Cardiac doses of accelerated partial breast irradiation with perioperative multicatheter interstitial brachytherapy

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A Correction to this article was published on 23 March 2021

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Abstract

Purpose

To quantify mean heart dose (MHD) and doses to the left anterior descending artery (LAD) and left ventricle (LV) in a retrospective series of patients who underwent perioperative accelerated partial breast irradiation with multicatheter interstitial brachytherapy (MIB-APBI).

Methods

Sixty-eight patients with low-risk left breast cancer were treated with MIB-APBI at our institution between 2012 and 2017. Interstitial tubes were inserted during the tumorectomy and sentinel node biopsy and APBI was started 6 days later. The prescribed dose was 34 Gy in 10 fractions (twice a day) to the clinical target volume (CTV). The heart, LAD, and LV were contoured and the distance between each structure and the CTV was measured. The MHD, mean and maximum LAD doses (LAD mean/max), and mean LV doses (LV mean) were calculated and corrected to biologically equivalent doses in 2‑Gy fractionation (EQD2). We also evaluated the impact of the distance between the cardiac structures and the CTV and of the volume receiving the prescribed dose (V100) and high-dose volume (V150) on heart dosimetry.

Results

Mean EQD2 for MHD, LAD mean/max, and mean LV were 0.9 ± 0.4 Gy (range 0.3–2.2), 1.6 ± 1.1 Gy (range, 0.4–5.6), 2.6 ± 1.9 Gy (range, 0.7–9.2), and 1.3 ± 0.6 Gy (range, 0.5–3.4), respectively. MHD, LAD mean/max, and LV mean significantly correlated with the distance between the CTV and these structures, but all doses were below the recommended limits (German Society of Radiation Oncology; DEGRO). The MHD and LV mean were significantly dependent on V100.

Conclusion

Perioperative MIB-APBI resulted in low cardiac doses in our study. This finding provides further support for the value of this technique in well-selected patients with early-stage left breast cancer.

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Funding

Univerzita Karlova v Praze (Charles University in Prague) – CZ, GAUK 100120. Mrs. Denisa Pohanková

Acknowledgements

We are very grateful to Bradley Londres for professional English language editing.

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Authors and Affiliations

  1. Dept. of Oncology and Radiotherapy, University Hospital and Medical Faculty, Sokolská 281, 500 05, Hradec Kralove, Czech Republic

    Veronika Novotná, Igor Sirák MD, Ph.D., Denisa Pohanková, Linda Kašaová, Jakub Grepl, Petr Paluska & Jiří Petera

  2. Dept. of Surgery, University Hospital and Medical Faculty, Hradec Kralove, Czech Republic

    Pavel Jandík, Petr Motyčka & Ahmed Asqar

  3. Clinical Study Center (CSC), Berlin Institute of Health, and Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany

    Lucie Kretzler

Authors
  1. Veronika Novotná
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  2. Igor Sirák MD, Ph.D.
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  3. Denisa Pohanková
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  11. Jiří Petera
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Corresponding author

Correspondence to Igor Sirák MD, Ph.D..

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Conflict of interest

V. Novotná, I. Sirák, D. Pohanková, P. Jandík, L. Kašaová, J. Grepl, P. Paluska, P. Motyčka, A. Asqar, L. Kretzler, and J. Petera declare that they have no competing interests.

Additional information

The original online version of this article was revised: The following Funding Information was missing. Funding Information: Univerzita Karlova v Praze (Charles University in Prague) – CZ, GAUK 100120. Mrs. Denisa Pohanková

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Novotná, V., Sirák, I., Pohanková, D. et al. Cardiac doses of accelerated partial breast irradiation with perioperative multicatheter interstitial brachytherapy. Strahlenther Onkol 197, 288–295 (2021). https://doi.org/10.1007/s00066-020-01699-5

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